A Empirical Study on "Quasi-Market" in Social Care Service

自2000年引入长期护理保险制度以来，地方政府直接为老年人提供的护理服务有所减少。相反，私人护理提供者，作为公司和非营利组织，已经进入护理服务市场。我研究了一些护理提供者，他们在当地政府的支持下运作。其中，广岛公益团体和京都公益团体是值得关注的案例。尤其是后者，更是在长期护理保险制度下的新形势下成长起来的。其成功的原因在于针对相应的护理消费者进行了运营改革，公共长期护理保险制度创造了老年人护理服务部门的准市场。因此，地方政府成为保险人，必须在长期护理保险制度下协调服务用户和服务提供者。此外，他们还必须帮助需要福利和保健服务但从保险中受益的老年人。这些地方政府服务在不断摸索中发展，今后护理服务领域的准市场将逐步形成。我打算继续研究它。

Since the long-term care insurance system was introduced in 2000, care services which local governments directly supplied for the elderly have been decreased. Instead, private care providers, as companies and NPOs, have been going into the care service market. I researched some care providers which have operated with back up from local government. Among them Hiroshima public corporation of welfare service and Kyoto welfare service association are interesting cases. Especially the latter is curious because it is growing up in the new circumstance under the long-term care insurance system. Its success may be attributed to reforms of operation which aim at corresponding care consumers.The public long-term care insurance system created a quasi-market in care service sector for the elderly. Consequently local governments became insurers who have to coordinate service user with service provider under the long-term care insurance system. Moreover they have to aid the elderly who need welfare and health services but benefit from the insurance. These local government services are developing by trial and error.The quasi-market in care service sector hereafter will grow up. I intend to go on researching it.